Akromioklaviküler Eklem Çıkığı Tedavisinde Çift Düğme İmplant ile Fiksasyon Fonksiyonel Sonuçlarda Klavikuler Kanca Plaktan Daha İyi Performans Göstermektedir

Öz

Amaç: Akromiyoklaviküler eklem çıkığı (AKEÇ) için en uygun cerrahi tedavi yöntemi konusunda halen bir fikir birliği bulunmamaktadır. Bu çalışmada, hook plak (HP) ve suture-button (SB) yöntemleri ile yapılan tedavilerin fonksiyonel ve radyolojik sonuçları karşılaştırıldı. Yöntem: Haziran 2010 – Haziran 2023 tarihleri arasında Rockwood tip III ve V AKEÇ nedeniyle ameliyat edilen hastalar retrospektif olarak incelendi. Grup I’de HP, Grup II’de SB ile tedavi edilen hastalar yer aldı. Postoperatif değerlendirmede eklem hareket açıklığı (EHA), Constant–Murley Skoru (CMS) ve American Shoulder and Elbow Surgeons (ASES) skoru kullanıldı. Radyolojik incelemede korakoklaviküler mesafe (KKM) ölçümleri ve Rockwood sınıflaması değerlendirildi. Bulgular: Çalışmaya 62 hasta (47 erkek, 15 kadın; ort. yaş 29,2±16,1 yıl) dahil edildi ve ortalama takip süresi 52,9±20,5 ay idi. Anatomik redüksiyon %87 hastada sağlandı. Her iki grupta CMS (53,8±6,4’ten 89,7±5,4’e) ve ASES skorlarında (40,4±7,4’ten 89,0±7,8’e) anlamlı iyileşme görüldü (p<0,01). SB grubunda abduksiyon (160° vs. 153°) ve fleksiyon (172° vs. 162°) değerleri daha yüksekti. KKM her iki grupta da anlamlı olarak azaldı. Komplikasyon oranları benzer bulunmasına rağmen implant çıkarma yalnızca KP grubunda gerekti. Sonuç: Hem HP hem de SB yöntemi akut AKEÇ tedavisinde etkili olmakla birlikte, SB fiksasyonu daha iyi fonksiyonel sonuçlar, daha geniş omuz eklem hareket açıklığı ve implant çıkarma gereksiniminin ortadan kalkmasıyla öne çıkmaktadır. Bu nedenle SB yöntemi özellikle genç ve aktif hastalar için daha uygun bir cerrahi seçenek olarak değerlendirilebilir.

Anahtar Kelimeler

• Akromiyoklaviküler eklem çıkığı
• Hook plak fiksasyonu
• Çift düğme fiksasyonu
• Fonksiyonel sonuçlar.

Suture-Button Fixation Outperforms Hook Plate in Functional Outcomes After Acromioclavicular Joint Dislocation

Öz

Objective: There is no consensus on the optimal surgical treatment for acromioclavicular joint separation (ACJD). This study aimed to compare the functional and radiological outcomes of hook plate (HP) fixation and suture-button (SB) fixation. Methods: Patients who underwent surgery for Rockwood type III and V ACJD between June 2010 and June 2023 were retrospectively reviewed. Group I included patients treated with HP and Group II included patients treated with SB. Postoperative outcomes were assessed using range of motion (ROM), Constant–Murley Score (CMS), and American Shoulder and Elbow Surgeons (ASES) score. Radiological evaluation included coracoclavicular distance (CCD) measurements and Rockwood classification. Results: Sixty-two patients (47 men, 15 women; mean age, 29.2±16.1 years) were evaluated with a mean follow-up of 52.9±20.5 months. Anatomical reduction was achieved in 87% of cases. Both groups showed significant postoperative improvement in CMS (53.8±6.4 to 89.7±5.4) and ASES scores (40.4±7.4 to 89.0±7.8) (p<0.01). Group II demonstrated superior ROM in abduction (160° vs. 153°) and forward flexion (172° vs. 162°). Postoperative CCD decreased significantly in both groups. Complication rates were comparable, but implant removal was required only in the HP group. Conclusion: Both fixation methods are effective for acute ACJD. However, SB fixation provides superior functional outcomes, greater shoulder mobility, and avoids the need for secondary implant removal, making it a favorable option, particularly for young and active patients

Anahtar Kelimeler

• Acromioclavicular joint dislocation
• Hook plate fixation
• Suture-button fixation
• Functional outcomes

Kaynakça

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